What are the complications of bilateral DJ stenting?

DJ stenting involves placing a small tube to keep the ureters open and allow kidney drainage in certain urologic conditions. While usually temporary, having stents in both left and right systems poses risks like migration, fractures, and recurrent infections. Understanding bilateral DJ stent complications helps assess if the benefits outweigh the problems that may occur. can consult to Best Urologist in Hyderabad.

What is a DJ stent?

A DJ stent, also called a double J stent, is a soft hollow tube inserted between the kidney and bladder. It looks similar to a curved straw, with a coil on both ends to prevent migration. DJ stents provide scaffolding to improve urine flow and allow drainage when obstruction has occurred.

Ureteral stenting came into practice in 1978 when Dr. DJ developed this specialized catheter design. Today, over a million patients undergo placement annually for issues like kidney stones, tumors pressing on ureters, strictures, trauma, etc. Stents are usually kept for 4-6 weeks then removed or replaced if needed.

Why are bilateral stents placed?

When both right and left urinary systems require stenting, bilateral DJ stents are used to bypass and drain both kidneys. Some reasons for double stenting include:

  • Large or multiple stones blocking both ureters
  • Fibrotic strictures impairing bilateral urine flow
  • Retroperitoneal fibrosis squeezing both sides
  • Bilateral ureteral injuries from trauma
  • Certain cancers affecting urine drainage
  • Congenital defects obstructing bilateral systems
  • Severe cases of vesicoureteral reflux
  • Recovery after major kidney surgeries

Placing only unilateral stents when both sides are problematic can cause further kidney damage. So specialist urologists recommend bilateral drainage until definitive surgeries can be performed.

Complications of Bilateral DJ Stenting

While most patients tolerate bilateral DJ stents, many experience irritating urinary symptoms. And the longer stents remain in place, higher the risks of adverse events like:

  • Chronic flank and pelvic pain
  • Recurrent painful urinary tract infections
  • Inadequate drainage from encrustation
  • Stent migration or fragmentations
  • Loss of kidney function
  • Elevated risk of sepsis

Such problems may require frequent visits for stent exchanges or antibiotics to treat infections. Kidney function decline is also accelerated with bilateral obstruction. Let’s look closely at key complications.

Infection Risks

Having any foreign object in the urinary tract increases infection risk. With two stents bacterial contamination occurs more readily. Previous studies found about 23% of patients with bilateral stents developed UTIs requiring antibiotic therapy. Signs like smelly urine, bleeding, fever warrant immediate medical attention.

Encroachment Issues

The coil design that provides stability can become a nuisance as weeks go by. The ends may rub inside the kidney or bladder causing discomfort. Slowing of urine flow encourages mineral deposits along the stent walls. Buildup causes pain and urinary issues needing frequent changes.

Migration and Stent Failure

While stents have a low dislodgement rate of 2–7%, having two enhances issues. The stent may shift down from the kidney into the ureter or even come out completely. This leads to internal bleeding or obstruction, causing severe pain and infection. Fracturing is also more common in those with chronic kidney disease.

Kidney Function Decline

Bilateral stents that become clogged or infected substantially reduce urine outflow over time. This leads to backward pressure buildup causing kidney damage. Studies indicate patients with stents longer than 12 weeks show worse renal function loss. This must be avoided via proper monitoring and exchanges.

With over 8000 endourology procedures performed in his 25+ years career, patients routinely seek his skills for complex stenting cases. His methodical expertise gives the best chance for stabilization until definitive reconstructive options become available. Dr. Reddy also teaches other urologists the finer aspects of DJ stent placements.

DJ Stent Placement Bilateral Cost in Hyderabad

DJ Stent Placement Bilateral Cost in Hyderabad hospital fees, consumables, surgeon charges, medications for a 5-7 day stay. Costs increase if additional procedures are required for complications like infections or obstructions developing later on.


DJ stents provide internal drainage critically needed in some situations to prevent kidney loss. But issues like infection tend to occur more readily with stents placed on both sides. Working with an adept urologic surgeon minimizes risks during what is usually a temporary stabilization period. Close monitoring and timely exchanges preserve kidney function until definitive reconstruction is possible. 

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